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The effect of change in medical care protocol for primary headache patients visiting the emergency medical center

대한응급의학회지 2019년 30권 6호 p.584 ~ 592
이성유 ( Lee Seong-You ) - Eulji University College of Medicine Department of Emergency Medicine

서상원 ( Seo Sang-Won ) - Eulji University College of Medicine Department of Emergency Medicine
이장영 ( Lee Jang-Young ) - Eulji University College of Medicine Department of Emergency Medicine
이원석 ( Lee Won-Suk ) - Eulji University College of Medicine Department of Emergency Medicine
성원영 ( Sung Won-Young ) - Eulji University College of Medicine Department of Emergency Medicine

Abstract


Objective: University hospitals nationwide are experiencing a shortage of neurology residents and excessive workloads; new measures are required because a lack of neurologists in the emergency department (ED) leads to ED overcrowding. This study examined the effects of emergency medicine doctors taking over the role of neurologists in the treatment of primary headache patients visiting the ED.

Method: A study group of primary headache patients, who visited a single university hospital ED between 1 June and 31 October 2017 and were treated by an emergency medical doctor, was selected. The control group consisted of patients who met the same conditions as the study group and visited the ED during the same period in 2016 but were treated by a neurologist. The following variables between the two groups were compared: length of stay in the ED, medical expenses in the ED, and the time taken to decide on neuroimaging tests.

Results: This study was conducted on 300 patients in the control group and 94 patients in the study group. The study group showed a shorter time to decide on neuroimaging tests (64.4%, 95% confidence interval [CI], P<0.001), shorter length of stay in the ED (15.2%, 95% CI, P<0.001), and lower medical expenses (12.8%, 95% CI, P=0.011).

Conclusion: When emergency medicine doctors take over the neurologic medical care of primary headache patients in ED, it can be expected to reduce ED overcrowding and medical expenses.

키워드

Neurology; Emergency medicine; Emergency department overcrowding
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